Individual
LAURIE MARIE THERIOT ROLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
255 ENTERPRISE BLVD, SUITE 101, GREENVILLE, SC 29615-6300
(864) 454-8120
(864) 454-8125
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
34100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341008
—
SC
Enumeration date
11/27/2007
Last updated
05/25/2021
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